Current policies about 'care in the community' of the mentally ill, along with lurid
accounts of abuses, have led to the impression that the old, custodial mental hospitals
outside big cities were all dreadful 'bins' where human dignity was sacrificed to staff
routines. The author was in charge of a traditional institution near Cambridge for three
decades, during which it became internationally renowned for enlightened practices and the
nurturing of patients' rights and welfare. He tells the history of the hospital from its
founding in the nineteenth century to a period of traditional custodialism, during which
it suffered from lack of funds, physical neglect and low morale. He then tells of a number
of exciting changes: unlocking the wards, social therapy, administrative therapy,
therapeutic communities, and the rehabilitation programmes of the 1970s. It is a moving
story, part autobiography, part narrative history, and full of touching incidents - coping
with internal wrangles, inertia and relations with the community and reflecting the best
tradition of the caring professions. It can be argued that the work being done in some
institutions of this kind compares favourably with many current policies for the care of
the mentally ill.

'Little has been written by insiders about those great public mental hospitals which,
until recently, held in Britain over 100,000 patients. Hence everyone interested in recent
psychiatry and the role played in it by the psychiatric hospital will be delighted that
David Clark has recorded his personal memories of a life-time spent in running a large,
public psychiatric institution Trained at the Maudsley Hospital, Clark joined Fulbourn
Hospital, on the outskirts of Cambridge, back in the 1950s; he stayed on and transformed
the institution...

'In a book doubling as a history of the hospital and an autobiography Clark discusses
the changes he was able to effect and his thoughts about the present crisis in psychiatric
care. A rich irony reveals itself: our age, which has seen the agitation for the closing
of traditional asylums come to fruition, has also been the time when many of them have
been, at long last, most therapeutically innovative and successful.

'Frank, modest and written with a wry sense of humour, David Clark's account of a
career in Fulbourn is a rare document, fascinating to read and invaluable as historical
evidence. It is a pleasure to see it in print.'

- from the foreword by Roy Porter, Professor of the Social History of Medicine,
Wellcome Institute, London, author of Mind-Forg'd Manacles, editor of The Faber
Book of Madness and Co-editor of Discovering the History of Madness

David H. Clark studied Medicine at King's College, Cambridge and Edinburgh University,
trained in Psychiatry at the Maudsley Hospital, was appointed Medical Superintendent of
Fulbourn Hospital in 1953 and from 1971 until 1983 was Senior Consultant Psychiatrist at
the hospital. He is the author of Administrative Therapy (Tavistock, 1964), Social
Therapy in Psychiatry (Penguin, 1974; 2nd ed., Churchill Livingstone, 1982) and Descent
into Conflict 1945: A Doctor's War (Book Guild, 1995).